Certification

By clicking the submit button below the form you certify the following:

The information contained within this application is true to the best of my knowledge.

I understand that misrepresentation or fraudulent information may be grounds for loss of scholarship funds and/or required repayment.

I also understand that my application WILL NOT BE CONSIDERED if my application is not completed as instructed; if my academic transcripts are not attached; and until the WiTEACH Leadership Program Office has received the results of my FAFSA from the Financial Aid Office.

If named a recipient, I authorize UW-River Falls to release any non-private information listed in this application to the WiTEACH Leadership Program.

First Name*

Middle Name

Last Name*

Falcon ID*

E-mail*

Street Address*

Apartment or Unit Number

City*

State*

Postal/Zip Code*

Phone Number*

DEMOGRAPHICS: Providing the following demographic information is voluntary. This information will assist WiTEACH in evaluating student recruitment and retention policies. Scholarships are funded by donors and they often give these scholarships with the intent that they are awarded to students who meet very specific criteria. Please review the following criteria carefully and check any item that applies to you:

Gender

Female

Male

Ethnicity

Are you a new student (never attended UW-River Falls)?

Yes

No

Are you planning on enrolling full-time (12 or more credits per semester)?

Yes

No

If not planning on enrolling full-time, how many credits do you plan to take each semester?

How many total credits will you have at the start of fall term?

How many of your total credits are transfer credits?

Program of Study at UWRF

Expected date of UWRF graduation

Have you been accepted into the Teacher Education program?

Yes

No

Name of High School

Year of HS Graduation

List all previous colleges attended

APPLICATION

What questions do you have about Teacher Education at UWRF?

How do you picture WiTEACH helping you as a student and as a future teacher?